1|Page
AHIP 2025/2026 FINAL EXAM, PRACTICE EXAM AND
100% VERIFIED STUDYGUIDE NEWEST ACTUAL
EXAM COMPLETE 250 QUESTIONS AND
100%CORRECT DETAILED ANSWERS |ALREADY
GRADED A+
Mr. Kumar is considering a Medicare Advantage HMO and
has questions about his ability to access providers. What
should you tell him? - ANSWER-In most Medicare
Advantage HMOs, Mr. Kumar must generally obtain his
services only from providers who have a contractual
relationship with the plan (except in an emergency or
where care is unavailable within the network).
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Mr. Lopez has heard that he can sign up for a product
called "Medicare Advantage" but is not sure about what
type of plan designs are available through this program.
What should you tell him about the types of health plans
that are available through the Medicare Advantage
program? - ANSWER-They are Medicare health plans
such as HMOs, PPOs, PFFS, and MSAs.
Mr. Greco is in excellent health, lives in his own home, and
has a sizeable income from his investments. He has a
friend enrolled in a Medicare Advantage Special Needs
Plan (SNP). His friend has mentioned that the SNP
charges very low cost-sharing amounts and Mr. Greco
would like to join that plan. What should you tell him? -
ANSWER-SNPs limit enrollment to certain subpopulations
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of beneficiaries. Given his current situation, he is unlikely
to qualify and would not be able to enroll in the SNP.
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan
available in her area that does not include drug coverage.
She wants to enroll in the plan and enroll in a stand-alone
prescription drug plan. What should you tell her? -
ANSWER-She could enroll in a PFFS plan and a stand-
alone Medicare prescription drug plan.
Mrs. Walters is enrolled in her state's Medicaid program in
addition to Medicare. What should she be aware of when
considering enrollment in a Medicare Advantage (MA)
plan? - ANSWER-She cannot enroll in an MA Medical
Savings Account (MSA) plan.
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Mrs. Kelly, age 65, is entitled to Part A but has not yet
enrolled in Part B. She is considering enrollment in a
Medicare Advantage plan (Part C). What should you
advise her to do before she will be able to enroll in a
Medicare Advantage plan? - ANSWER-In order to join a
Medicare Advantage plan, she also must enroll in Part B.
Mr. Barker enjoys a comfortable retirement income. He
recently had surgery and expected that he would have
certain services and items covered by the plan with
minimal out-of-pocket costs because his MA-PD coverage
has been very good. However, when he received the bill,
he was surprised to see large charges in excess of his
maximum out-of-pocket limit that included a number of
AHIP 2025/2026 FINAL EXAM, PRACTICE EXAM AND
100% VERIFIED STUDYGUIDE NEWEST ACTUAL
EXAM COMPLETE 250 QUESTIONS AND
100%CORRECT DETAILED ANSWERS |ALREADY
GRADED A+
Mr. Kumar is considering a Medicare Advantage HMO and
has questions about his ability to access providers. What
should you tell him? - ANSWER-In most Medicare
Advantage HMOs, Mr. Kumar must generally obtain his
services only from providers who have a contractual
relationship with the plan (except in an emergency or
where care is unavailable within the network).
,2|Page
Mr. Lopez has heard that he can sign up for a product
called "Medicare Advantage" but is not sure about what
type of plan designs are available through this program.
What should you tell him about the types of health plans
that are available through the Medicare Advantage
program? - ANSWER-They are Medicare health plans
such as HMOs, PPOs, PFFS, and MSAs.
Mr. Greco is in excellent health, lives in his own home, and
has a sizeable income from his investments. He has a
friend enrolled in a Medicare Advantage Special Needs
Plan (SNP). His friend has mentioned that the SNP
charges very low cost-sharing amounts and Mr. Greco
would like to join that plan. What should you tell him? -
ANSWER-SNPs limit enrollment to certain subpopulations
,3|Page
of beneficiaries. Given his current situation, he is unlikely
to qualify and would not be able to enroll in the SNP.
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan
available in her area that does not include drug coverage.
She wants to enroll in the plan and enroll in a stand-alone
prescription drug plan. What should you tell her? -
ANSWER-She could enroll in a PFFS plan and a stand-
alone Medicare prescription drug plan.
Mrs. Walters is enrolled in her state's Medicaid program in
addition to Medicare. What should she be aware of when
considering enrollment in a Medicare Advantage (MA)
plan? - ANSWER-She cannot enroll in an MA Medical
Savings Account (MSA) plan.
, 4|Page
Mrs. Kelly, age 65, is entitled to Part A but has not yet
enrolled in Part B. She is considering enrollment in a
Medicare Advantage plan (Part C). What should you
advise her to do before she will be able to enroll in a
Medicare Advantage plan? - ANSWER-In order to join a
Medicare Advantage plan, she also must enroll in Part B.
Mr. Barker enjoys a comfortable retirement income. He
recently had surgery and expected that he would have
certain services and items covered by the plan with
minimal out-of-pocket costs because his MA-PD coverage
has been very good. However, when he received the bill,
he was surprised to see large charges in excess of his
maximum out-of-pocket limit that included a number of
